Remote CA Workers' Comp Claim Specialist

CCMSI; Oregon; Hybrid; USD 85,000 - 95,000; Full time

Benefits offered by this job

PTO 4 weeks

10 paid holidays in first year

Medical, Dental, Vision, Life, and DI

Job summary

CCMSI is seeking a California Workers' Compensation Claim Specialist to manage a dedicated portfolio of CA WC claims, lead investigations, determine compensability, and guide cases to timely resolutions. This role offers growth paths toward supervisory or management positions and emphasizes delivering high-quality service to clients and injured workers.

The position allows remote reporting with a 8:00 am - 4:30 pm (PST) schedule and a salary range of $85,000-$95,000 depending on experience.

Qualifications

• 10+ years of California Workers' Compensation claims handling experience, including full investigation, evaluation, and resolution.
• CAWCS, WCIRB, CPWC, or WCCA designation required.
• Strong analytical and negotiation abilities.
• Excellent internal and external communication.
• Proven experience handling complex and litigated California claims.
• Knowledge of lower-level claim position responsibilities.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims; negotiate disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program within authority.
• Negotiate settlements in accordance with corporate standards and state laws when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors.
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Compute disability rates in accordance with state laws.
• Coordinate effectively with clients, claimants and others throughout the process.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Comply with corporate claim handling standards and client instructions.

Skills

California WC claims

Investigations

Negotiation

Communication

Litigation experience

Lower-level claim knowledge

Analytical thinking

Client responsiveness

Education

Bachelor's degree (preferred)

Job description

CCMSI is seeking a California Workers' Compensation Claim Specialist to manage a dedicated portfolio of CA WC claims, lead investigations, determine compensability, and guide cases to timely resolutions. This role offers growth paths toward supervisory or management positions and emphasizes delivering high-quality service to clients and injured workers.

The position allows remote reporting with a 8:00 am - 4:30 pm (PST) schedule and a salary range of $85,000-$95,000 depending on experience.